August 23, 2006

Something like 92,000 Americans are currently on the United Network for Organ Sharing (UNOS) waiting list. Talk about sweating something out.

According to the UNOS Web site, 77 people luck out and receive a donated organ every day. Sadly, another 18 people die each day because a suitable organ never becomes available for transplant. And a good 3,700 new people join the waiting list every month.

They say about half of all the people on these donor waiting lists will die before a needed organ becomes available.

Expect these numbers to continue to rise as people live longer thanks to improved medical science and pharmaceuticals.

The thing about needing an organ is that it could happen to anyone. One day you’re sailing along in perfect health and then something goes awry and you need a fucking kidney or some bone marrow.

It seems to me we need a better system for this organ donation scam. I know the waiting lists are supposed to be based on need or length of time on the list, but you can bet that more than a few lucky (rich or otherwise connected) people have been bumped up the list over the years to get a life-saving organ they probably weren’t entitled to. That’s life, I guess, but surely there’s got to be a better way to manage these valuable resources.

Depending upon where you live, you can sign up to be an organ donor when you get or renew your driver’s license. This is something I’ve never done and I’m in the clear majority on this one.

Only about 30 percent of Americans are registered organ donors. Something like 20,000 transplantable organs are buried or cremated every year. For whatever reason, people just aren’t comfortable with the idea of having their parts (or their loved ones’ parts) mined from their corpses and distributed much like used auto parts. It’s not rational but it’s a fact.

Further undermining the organ-donation process is the fact that you don’t have to be a registered organ donor to be eligible to receive a donated organ if you were ever in need of one. Doesn’t seem right but it’s true and it provides an admittedly shallow “excuse” for those who don’t want to register as organ donors. After all, why should I register and “give away” my organs to someone in need who didn’t even bother to register to donate his or her organs when they die?

Here’s my solution:

First, you don’t get on the waiting list until you register to donate your own organs. Period. You might have a faulty heart, but there’s nothing wrong with your kidneys or pancreas or corneas. It has to be mandatory. You have to pay to play.

And if you’ve ever received a donated organ, you’re a registered donor for life. No exceptions.

Second, we need to create a better system for rewarding those who have or will donate their organs once they die. Doing the right thing should be enough but it’s not and we have to stop kidding ourselves.

I suggest that donated organs be treated just like any other asset because that’s what they are. Just like stocks or cash or homes or insurance policies, a person’s organs are property and are extremely valuable. The problem is that most surviving family members, the folks who stand to inherit the deceased’s property, almost never need an organ. At least not at that very moment.

We’re not quite at the point where a husband can put his dead wife’s lungs or heart up for auction on eBay (yet) so we have to find some way to adequately compensate the relatives of organ donors. The organs have to be iced up and shipped out and transplanted in quick order, but that shouldn’t be the end of the story for the surviving relatives of the deceased.

I hate to be so blunt and tactless about this, but we need more of a quid pro quo approach to this organ donating business. I say that the immediate surviving family of a deceased organ donor should receive special consideration and credit for, indirectly, donating the organ assets of their loved one to those on the waiting list.

If your mother dies of a heart attack and is a registered donor, they can go right ahead and start harvesting the lungs, cornea, bone marrow, kidneys, liver, etc. and ship them off to the lucky person(s) next on the waiting list for each respective organ. And the immediate family (meaning surviving spouse and children only) are given credit for each organ they’ve indirectly donated to those in need. In this example, the family gets a notation in the organ registry for having “provided” all these organs except, obviously, for the heart.

Let’s say that three years down the road, the husband starts suffering from liver failure. Say he hit the bottle real hard throughout most of his life but really cranked it up a couple notches after his wife croaked from the heart attack. This guy needs a liver transplant. Like yesterday. Because his wife was a registered donor and already kicked down a liver at the time of her death, this guy gets what we’ll call “priority” consideration for the next available and matching liver that comes down the pipe.

The same priority consideration would be extended to the mother’s children as well.

Yes, I know you can’t bump one guy from the bottom of the list to the top of the list just because his wife died and donated all her organs. It’s going to require a little work and common sense to devise some equitable formula that rewards people for registering to donate their organs. Start out simple: If you need an organ and an immediate family member hasn’t died and donated his or her organs, you’re definitely going to the bottom of the list.

Yes, I realize that one donor could potentially have 8 or 12 or even 15 immediate family members eligible for the priority consideration. Eventually, you could reach a point where there will be more people with priority status than not. But so what? Chances are none of the surviving family members will ever have to cash in the chip their dead relative(s) left behind.

Think about how this type of system would increase the number of people who register to donate their organs. If you knew that by giving away your organs you would be at least increasing the odds that your children or your spouse will get a second chance at life, why wouldn’t you become a registered donor?

There’s no way to sugarcoat this. People always want to know what’s in it for them? Otherwise, according to current statistics, a good 7 in 10 of us will just blow it off and let our organs go to waste.

You never really think about donating your organs until you or someone you know needs one. It’s fucking human nature. No one wants to think or talk about death so it’s real easy to avoid any serious discussion about donating your organs. They’re your fucking organs. You should be able to do whatever you want with them.

If we can come up with an incentive-based system that rewards people in tangible ways for donating their organs, people will fucking do it.